children and family futures 4940 irvine boulevard, suite 202 irvine, ca 92620

Research Findings from the Sacramento County Dependency Drug

Court: Systems Changes and its Impact on Permanency

Sharon M. Boles, Ph.D.Nancy K. Young, Ph.D.

Children and Family Futures

February 1, 2007February 1, 2007Anaheim, CAAnaheim, CA

Children and Family Futures4940 Irvine Boulevard, Suite 202

Irvine, CA 92620714.505.3525 Fax 714.505.3626

www.cffutures.com

Sacramento County StatisticsSacramento County Statistics

Sacramento County population: 1.5 millionSacramento County population: 1.5 million

In 2004, there were approximately 7,000 In 2004, there were approximately 7,000 substantiated child abuse/neglect referrals, in substantiated child abuse/neglect referrals, in Sacramento.Sacramento.11

Approximately 60% of child welfare cases in Approximately 60% of child welfare cases in Sacramento involve families affected by Sacramento involve families affected by substance usesubstance use

1. Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus, W., Magruder, J., Exel, M., Conley, A., Smith, J., Dunn, A., Frerer, K., Putnam Hornstein, E., & Kaczorowski, M.R., (2006). Child Welfare Services Reports for California. Retrieved May 1, 2006, from University of California at Berkeley Center for Social Services Research website. URL: <http://cssr.berkeley.edu/CWSCMSreports/>

Five Components of ReformFive Components of Reform

1.1. Comprehensive cross-system joint trainingComprehensive cross-system joint training

2.2. Substance Abuse Treatment System of CareSubstance Abuse Treatment System of Care

3.3. Early Intervention SpecialistsEarly Intervention Specialists

4.4. Recovery Management Specialists (STARS)Recovery Management Specialists (STARS)

5.5. Dependency Drug CourtDependency Drug Court

Reforms have been implemented over the past eleven Reforms have been implemented over the past eleven yearsyears

Sacramento County’s Sacramento County’s Comprehensive ReformComprehensive Reform

Five Components of Sacramento Five Components of Sacramento

County’s Comprehensive ReformCounty’s Comprehensive Reform

Three Levels of TrainingThree Levels of Training

AOD basics for all staff – 4 days requiredAOD basics for all staff – 4 days required

AOD screening, brief intervention, AOD screening, brief intervention, motivational enhancement and AOD motivational enhancement and AOD treatment – 4 days required of all case treatment – 4 days required of all case carrying workerscarrying workers

Group intervention skills – 4 days required of Group intervention skills – 4 days required of all ADS staff and voluntary for any CPS all ADS staff and voluntary for any CPS division staffdivision staff

1. Comprehensive cross-system joint training

2. Substance abuse treatment system of 2. Substance abuse treatment system of carecare

Child welfare clients have priority access to Child welfare clients have priority access to treatmenttreatment

Immediate access to substance abuse Immediate access to substance abuse servicesservices

Group services expansion and Group services expansion and implementation of pre-treatment groupsimplementation of pre-treatment groups



3. Early Intervention Specialists3. Early Intervention Specialists

Review of every court petition to determine Review of every court petition to determine if substance use disorders may be presentif substance use disorders may be present

Immediate access to intervention and Immediate access to intervention and assessment at court hearingsassessment at court hearings

Immediate authorization of publicly-funded Immediate authorization of publicly-funded treatment servicestreatment services



4. Recovery Management Specialists (STARS)4. Recovery Management Specialists (STARS)

Motivational enhancementMotivational enhancement Gender-specific servicesGender-specific services Immediate access to recovery management Immediate access to recovery management

and treatment servicesand treatment services Provider orientation of providing hope and Provider orientation of providing hope and

accountability accountability Compliance monitoring—twice monthliesCompliance monitoring—twice monthlies



5. Dependency Drug Court5. Dependency Drug Court

Parallel system to dependency petitionParallel system to dependency petition Non-adversarial approachNon-adversarial approach 30, 60 and 90-day compliance hearings30, 60 and 90-day compliance hearings Structured incentives for compliance and Structured incentives for compliance and

sanctions for non-compliancesanctions for non-compliance Voluntary participation in on-going servicesVoluntary participation in on-going services



Models of Family Drug Treatment CourtsModels of Family Drug Treatment Courts

The Sacramento Initiative added a third primary model of family drug The Sacramento Initiative added a third primary model of family drug courts to the two previously described in the literature. The three courts to the two previously described in the literature. The three

models models are:are:

Integrated (e.g., Santa Clara, Reno, Suffolk)Integrated (e.g., Santa Clara, Reno, Suffolk) Both dependency matters and recovery management conducted in the same Both dependency matters and recovery management conducted in the same

court with the same judicial officercourt with the same judicial officer

Dual Track (e.g., San Diego)Dual Track (e.g., San Diego) Dependency matters and recovery management conducted in same court with Dependency matters and recovery management conducted in same court with

same judicial officer during initial phase same judicial officer during initial phase If parent is noncompliant with court orders, parent may be offered DDC If parent is noncompliant with court orders, parent may be offered DDC

participation and case may be transferred to a specialized judicial officer who participation and case may be transferred to a specialized judicial officer who increases monitoring of compliance and manages only the recovery aspects of the increases monitoring of compliance and manages only the recovery aspects of the casecase

Parallel (e.g., Sacramento)Parallel (e.g., Sacramento) Dependency matters are heard on a regular family court docket Dependency matters are heard on a regular family court docket Specialized court services offered before noncompliance occursSpecialized court services offered before noncompliance occurs Compliance reviews and recovery management heard by a specialized court Compliance reviews and recovery management heard by a specialized court

officerofficer

Jurisdiction & Disposition

Hearings

Detention Hearing

Child in Custody

STARSVoluntary

Participation

STARSCourt OrderedParticipation

Sacramento Sacramento County County Dependency Drug Dependency Drug Court ModelCourt Model Level 1

DDC Hearings

30 Days

60 Days

90 Days

Level 3Monthly Hearings

Level 2

Weekly or Bi-Weekly Hearings

180 DaysGraduation

Early Intervention Specialist (EIS) Assessment &Referral to STARS

Court Ordered to

STARS & 90 Days of DDC

Sacramento County Prior to Sacramento County Prior to Dependency Drug CourtDependency Drug Court

18.5% reunification rate18.5% reunification rate

Parents unable to access AOD treatmentParents unable to access AOD treatment

Social workers, attorneys, courts often Social workers, attorneys, courts often uninformed on parent progressuninformed on parent progress

Drug testing not uniform and results often Drug testing not uniform and results often delayeddelayed

Evaluation Conceptual ModelSystem• Environment and

Context of Partner Agencies– Treatment– CWS– Court

Family• Strengths &

Needs• AOD Severity• CW Risks

DDC Program• Court

oversight• Intensive

case supervision

• Treatment linkages

• Systems’ Collaboration

Key Outcomes• Treatment

– Access to Treatment

– Engagement– Retention– Completion– Functional Status

• Child Welfare Services

– Safety– Permanence

• Dependency Court– Case Resolution– Compliance with

statutory timelines– Nature of Court

Hearings

1. Child Protective Services 1. Child Protective Services DivisionDivision

2. Alcohol and Drug Services 2. Alcohol and Drug Services DivisionDivision

Child demographicsChild demographics Parent demographicsParent demographics Child placementsChild placements Child reunificationsChild reunifications Subsequent referralsSubsequent referrals Court ordersCourt orders

EIS system statisticsEIS system statistics Preliminary AssessmentsPreliminary Assessments STARS intake logSTARS intake log STARS twice monthliesSTARS twice monthlies California Alcohol & Drug California Alcohol & Drug

Data System (CADDS)-now Data System (CADDS)-now CalOMSCalOMS

CADDS supplemental dataCADDS supplemental data DDC court hearingsDDC court hearings

Multiple Data SourcesMultiple Data Sources

3. Juvenile and Dependency 3. Juvenile and Dependency CourtCourt

Monthly system statisticsMonthly system statistics

Participant GroupsParticipant Groups

ParentsParents ChildrenChildren

ComparisonComparison 111111 173173

Year 1 DDCYear 1 DDC 324324 432432





Parents and Children in the EvaluationParents and Children in the Evaluation

111173

324432

249

429

274

485449

741

442

731

0

100

200

300

400

500

600

700

800

900

1000

Comparison DDC YR 1 DDC YR 2 DDC YR 3 DDC YR 4 DDC YR 5

Parents Children

2424MosMos

1212MosMos

2424MosMos

2424MosMos

2424MosMos

Child Demographic CharacteristicsChild Demographic Characteristics 2991 children: 173 comparison, 2818 DDC

Overall, 51.4% were girls and 48.6% were boys

46.7% Caucasian 27.9% African American 20.4% Hispanic 3.2% Asian/Pacific Islander 1.8 % American Indian/Alaskan Native

There were no cohort differences in terms of gender

There were significantly more American Indian/Alaskan Native children in the comparison group (4.6%) than the DDC group (1.6%)

Parent Demographic CharacteristicsParent Demographic Characteristics

1849 participants: 111 comparison, 1738 DDC

Overall, 70.0% of the participants were women, approximately 32 years of age

52.0% Caucasian 20.2% Hispanic 20.0% African American 3.0% American Indian/Alaskan Native 3.0% Asian/Pacific Islander 1.7% “other”

There were no cohort differences in terms of gender or race/ethnicity

Parent Baseline CharacteristicsParent Baseline Characteristics 84.2% were unemployed, 46.0% had less than a high school education 22.0% were pregnant at treatment admission 30.9% reported a disability impairment 30.7% reported being diagnosed with chronic

mental illness 41.1% were homeless at treatment admission

50.8% reported methamphetamine as their primary drug problem, 18.0% marijuana, 16.3% alcohol, 9.5% cocaine/crack, 2.5% heroin

There were no cohort differences in any of these variables

Gender differences were found with all of the baseline characteristics

Baseline Characteristics with Baseline Characteristics with Significant Gender DifferencesSignificant Gender Differences

74.4

87.8

39.6

48.4

22.0

34.1

12.7

38.132.3

44.4

0

20

40

60

80

100

Per

cen

t

Unemployed*** Less than a HighSchool

Education**

DisabilityImpairment***

Chronic MentalIllness***

Homeless***

Men (n=414) Women (n=1118)**p<.01; ***p<.001

Primary Drug Problem by GenderPrimary Drug Problem by Gender

*p<.05; **p<.01, ***p<.001

2.4 2.5

22.2

14.0

46.452.4

6.010.7

21.0 16.9

0

20

40

60

80

Perc

en

t

Heroin Alcohol*** Methamphetamine* Cocaine** Marijuana

Men (n=414) Women (n=1118)

Treatment Admission Rates***Treatment Admission Rates***

53.2

84.8

0

20

40

60

80

100

Perc

ent

Comparison (n=111) DDC (n=1738)

***p<.001

Gender Differences in Treatment Gender Differences in Treatment Admission Rates***Admission Rates***

73.9

86.7

0

20

40

60

80

100

Perc

ent

Men (n=560) Women (n=1289)

***p<.001

Mean Number of Treatment Admissions***Mean Number of Treatment Admissions***

1.4

2.9

0

0.5

1

1.5

2

2.5

3

Num

ber


***p<.001

Gender Differences in Mean Number of Gender Differences in Mean Number of Treatment Admissions**Treatment Admissions**

1.5

2.8

0

0.5

1

1.5

2

2.5

3

Num

ber

Men (n=414) Women (n=1118)

**p<.01

Treatment Modality***Treatment Modality***

72.2

57.1

27.8

42.9

0

20

40

60

80

100

Perc

ent

Outpatient Residential


***p<.001; no gender differences were found in terms of treatment modality

Average Days Per Treatment Episode*Average Days Per Treatment Episode*

114.5

85.0

0

50

100

150

Da

ys


* p<.05

Average Days Per Treatment Episode by Average Days Per Treatment Episode by Gender***Gender***

99.2

81.9

0

50

100

150

Da

ys

Men (n=352) Women (n=1040)

*** p<.001

Treatment Discharge Status*Treatment Discharge Status*

56.865.1

43.2

34.9

0

20

40

60

80

100

Per

cent

Satisfactory Unsatisfactory


* p<.05; no gender differences were found in terms of discharge status

Treatment Discharge Status by Treatment Discharge Status by Primary Drug Problem***Primary Drug Problem***

***p<.001

50.3

71.366.1

60.2 61.9

49.7

28.733.9

39.8 38.1

0

20

40

60

80

Perc

en

t

Satisfactory Unsatisfactory

Heroin (n=181) Alcohol (n=623)

Methamphetamine (n=2039) Cocaine/Crack (n=465)

Marijuana (n=465)

12-Month Child Placement Outcomes12-Month Child Placement Outcomes

18.5

35.330.6

21.1

13.3

3.4

9.8

24.919.7

3.1

0

10

20

30

40

50

Perc

ent

Reunification*** Adoption** Guardianship*** ContinuedReunificationServices***

Long-TermPlacement***


**p<.01; ***p<.001

Time to Reunification at 12 Time to Reunification at 12 MonthsMonths

210.8 193.6

0

50

100

150

200

250

Day

s


n.s.

24-Month Child Placement Outcomes24-Month Child Placement Outcomes

27.2

43.6

31.822.6

13.34.5 1.7

14.018.5

3.3

0

20

40

60

80

Perc

ent

Reunification*** Adoption** Guardianship*** ContinuedReunificationServices***

Long-TermPlacement***

Comparison (n=173) DDC (n=1346)**p<.01; ***p<.001

Time to Reunification at 24 Time to Reunification at 24 MonthsMonths

300.7280.8

0

50

100

150

200

250

300

350

Day

s


n.s.

0

20

40

60

80

Pe

rce

nt

Reunification* Adoption*** Guardianship ContinuedReunification

Services*

Long-TermPlacement*

Heroin (n=39) Alcohol (n=232) Methamphetamine (n=763)

Cocaine/crack (n=177) Marijuana (n=246)

24-Month Child Placement Outcomes 24-Month Child Placement Outcomes by Parent Primary Drug Problemby Parent Primary Drug Problem

*p<.05 ***p<.001

33.2

48.5

42.8

24.8 24.923.1

6.0 7.14.6

14.2

7.1

13.8

6.5

3.2

5.4

0

10

20

30

40

50

Pe

rce

nt

Reunification*** Adoption Guardianship ContinuedReunification

Services**

Long-TermPlacement

African American (n=416) Hispanic (n=309) Caucasian (n=739)

24-Month Child Placement Outcomes 24-Month Child Placement Outcomes by Race/Ethnicity of the Childby Race/Ethnicity of the Child

**p<.01; ***p<.001

Recidivism RatesRecidivism Rates

0.01.1

6.1

0123456789

10

Per

cen

t

Comparison Court Ordered NationalStandard

24-Month Cost Savings Due to 24-Month Cost Savings Due to Increased Reunification RatesIncreased Reunification Rates

Preliminary FindingsPreliminary Findings Takes into account the reunification rates, time of out-of-home Takes into account the reunification rates, time of out-of-home

care, time to reunification, and cost per monthcare, time to reunification, and cost per month

27.2% - Reunification rate for comparison group children27.2% - Reunification rate for comparison group children 43.6% - Reunification rate for court-ordered DDC group children43.6% - Reunification rate for court-ordered DDC group children 221 Additional DDC children reunified221 Additional DDC children reunified

33.1 – Average months in out-of-home care for comparison 33.1 – Average months in out-of-home care for comparison group childrengroup children

9.4 - Average months to reunification for court-ordered DDC 9.4 - Average months to reunification for court-ordered DDC childrenchildren

23.7 month differential23.7 month differential

$10,049,036 Estimated Savings in Out-of-Home care $10,049,036 Estimated Savings in Out-of-Home care costscosts

children and family futures 4940 irvine boulevard, suite 202 irvine, ca 92620

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